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OBJECTIVESurgery for medically refractory epilepsy (RE) is an underutilized treatment modality, despite its efficacy. Laser interstitial thermal therapy (LITT), which is minimally invasive, is increasingly being utilized for a variety of brain lesions and offers comparable seizure outcomes. The aim of this study was to report the national trends of open surgical procedures for RE with the advent of LITT.METHODSData were extracted using the ICD-9/10 codes from the Nationwide Inpatient Sample (NIS, 2012–2016) in this retrospective study. Patients with a primary diagnosis of RE who underwent either open surgeries (lobectomy, partial lobectomy, and amygdalohippocampectomy) or LITT were included. Patient demographics, complications, hospital length of stay (LOS), discharge disposition, and index hospitalization costs were analyzed. Propensity score matching (PSM) was used to analyze outcomes.RESULTSA cohort of 128,525 in-hospital patients with RE was included and 5.5% (n = 7045) of these patients underwent either open surgical procedures (94.3%) or LITT (5.7%). LITT is increasingly being performed at a rate of 1.09 per 1000 epilepsy admissions/year, while open surgical procedures are decreasing at a rate of 10.4/1000 cases/year. The majority of procedures were elective (92%) and were performed at large-bed-size hospitals (86%). All LITT procedures were performed at teaching facilities and the majority were performed in the South (37%) and West (30%) regions. The median LOS was 1 day for the LITT cohort and 4 days for the open cohort. Index hospitalization charges were significantly lower following LITT compared to open procedures ($108,332 for LITT vs $124,012 for open surgery, p < 0.0001). LITT was associated with shorter median LOS, high likelihood of discharge home, and lower median index hospitalization charges compared to open procedures for RE on PSM analysis.CONCLUSIONSLITT is increasingly being performed in favor of open surgical procedures. LITT is associated with a shorter LOS, a higher likelihood of being discharged home, and lower index hospitalization charges compared to open procedures. LITT is a safe treatment modality in carefully selected patients with RE and offers an opportunity to increase the utilization of surgical treatment in patients who may be opposed to open surgery or have contraindications that preclude open surgery.

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Cauliflower-like NiCo 2 S 4 nanoparticles (NPs) for use as battery-type materials have been synthesized via a simple one-step route solvothermal method with thioacetamide (TAA) as the sulfur source. The synthesis of the Ni-Co precursors and the S 2− anion exchange reactions occur at the same time, which is timeeffective and cost-effective compared to other methods. The obtained NiCo 2 S 4 NPs display very competitive electrochemical performance (a specific capacitance of 2480 F g −1 is achieved at a current density of 0.5 A g −1 , excellent rate capability with 68% of the original capacitance remained at 10 A g −1 and ideal cycle stability with 80% capacitance remained after 3000 cycles) with high mass-loading (5 mg cm −2 ). In addition, low-cost activated balsam pear pulp (ABPP) is developed as a capacitor-type carbon material for supercapacitors with ideal electrochemical performances. The asymmetric hybrid capacitors (AHCs) are further assembled into pouch cells using battery-type NiCo 2 S 4 NPs as the positive electrode, capacitor-type ABPP as the negative electrode and flexible carbon papers as the current collector. The AHCs demonstrate high power density (3.52 kW kg −1 at an energy density of 3.72 Wh kg −1 ) and cycle stability (72.4% after 9000 cycles).

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